Video-assisted thoracoscopic apical bullectomy and talc poudrage is an effective treatment for spontaneous pneumothoraces with a low complication rate and recurrence rate and only minor changes in pulmonary function at 1 year. Discover the world's research 20+ million members
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What is talc poudrage used for?
Thoracoscopy with talc poudrage is a preferable alternative to chemical sclerosis or thoracotomy for treating pneumothoraces in patients with cystic fibrosis. The procedure may be performed under regional anesthesia and allows rapid …
Does thoracoscopy with talc poudrage produce a pleurodesis?
There were no complications, and the patients had minimal pleural pain. Follow-up ranged from 6 months to 4 years. No patient has had a recurrent pneumothorax on the treated side. Thoracoscopy with talc poudrage is a preferable alternative to chemical sclerosis or thoracotomy for treating pneumothoraces in patients with cystic fibrosis.
What is the prognosis of talc pleurodesis for pleural effusion?
Dec 01, 1986 · Talc poudrage in the treatment of spontaneous pneumothoraces in patients with cystic fibrosis. ... Thoracoscopy with talc poudrage is a preferable alternative to chemical sclerosis or thoracotomy for treating pneumothoraces in patients with cystic fibrosis. The procedure may be performed under regional anesthesia and allows rapid and complete ...
What is talc slurry used for in thoracoscopy?
The indications, technique, and results of thoracoscopic talc poudrage in the two clinical settings of pneumothorax and recurrent pleural effusion in chronically ill patients are reported. Forty patients underwent this treatment between May 1982 and September 1989. The patients ranged in age from 10 months to 78 years.
What is VATS in surgery?
Background Video-assisted thoracoscopic surgery (VATS) is an increasingly common treatment for recurrent or persistent primary spontaneous pneumothorax (PSP). Surgery usually involves diffuse treatment of the pleura and possible targeted therapy to areas of bullous disease. The purpose of this large cohort study was to examine incidence of recurrence after VATS and identify predictors of outcome.
What is VATS in PSP?
Video-assisted thoracoscopic surgery (VATS) for pneumothorax is associated with a marked reduction in recurrence to around 3%. 1 Without intervention, recurrence rates after primary spontaneous pneumothorax (PSP) are variably reported, with studies quoting rates as low as 26% and as high as 49% at 1 year. 2#N#,#N#3 VATS is typically well tolerated, increasing in popularity and is the procedure of choice in many centres. 4#N#,#N#5
How effective is talc in pleurodesis?
Talc is a highly effective pleurodesis agent when administered either via poudrage or slurry in patients with pleural effusion or pneumothorax. Success rates are similar for the two primary modes of administration: 87 percent (189 of 217) for talc slurry and 93 percent (988 of 1,062) for talc poudrage. The overall success rate is 91 percent in the treatment of pneumothorax (570 of 621) and in pleural effusion (659 of 723). The short-term adverse effects include fever, pain, infection (local and empyema), and respiratory failure, the latter probably being dose related. Long-term safety does not appear to be an issue if the asbestos-free product is used. Since the success rate does not appear to be dose related and there is some evidence to suggest that adverse effects may be associated with larger doses, we recommend pleurodesis, via poudrage or slurry, with a 5-g dose of talc.
Is talc a pleurodesis agent?
Talc is a highly effective pleurodesis agent when administered either via poudrage or slurry in patients with pleural effusion or pneumothorax. Success rates are similar for the two primary modes of administration: 87 percent (189 of 217) for talc slurry and 93 percent (988 of 1,062) for talc poudrage.
What is talc sheet?
Talc is a tri-layered magnesium sheet silicate that has significant lubricative properties that make it useful in cosmetic as well as industrial applications. The basic talc structure was determined in 1934
What are the risks of intrapleural talc?
Several safety aspects should be considered with intrapleural talc: (1) short-term, procedure-related issues such as pain, fever, infection, systemic embolization, hemodynamic compromise, and respiratory failure; and (2) long-term effects on pulmonary function, survival, and risk of malignancy.
Is talc sterile?
While talc is not packaged sterilely by the manufacturer, limitation on the number of micro-organisms is a part of USP specifications and total bacteria count cannot exceed 500/g. Despite the long-term use of talc for pleurodesis, there is no standard method of sterilization.
Material and Methods
Two chest drains are inserted under local infiltration anesthesia. Transparent plastic tubes, eg, Argyle trocar catheters (size 24 or 28) or Mayon plastic tubes with internal diameter of £ or & inch are used.
Results
When the jet of oxygen passes through the “T” connection into the pleural cavity, it produces a Venturi effect which draws the talc powder along with it into the pleural cavity (interrupted arrow, Fig 1 ). One can actually see the powder surging through the transparent chest tube.
Acknowledgment
I wish to thank Professor G.B. Ong, head of the Department of Surgery, University of Hong Kong, for his advice and encouragement.